Outcome of Meningioma Surgery in Octogenarians

Introduction : There is quite an ambiguity regarding the decision of whether to resect meningiomas in older adults because of wide variability in reported mortality rates, which range from 1.8 to 45%, and systemic complications. Elderly was defined as age >65-70 years. We present our experience in patients over 80 with meningiomas and analyze their outcome. Methods : We review a series of 25 patients above 80 who were operated for meningioma from 2003 to 2013 and had at least 6 months of follow-up. The patient files and imaging studies were evaluated retrospectively. Neurological and systemic complications of surgery were recorded and were analyzed in reference to the preoperative comorbidities. Results : Of the 25 patients operated, 1 patient with significant intracerebral preoperative hemorrhage and 1 patient with an intraosseous meningioma were excluded from analysis. Overall 18 patients (78%) had good outcome and 5 (22%) had a bad outcome, where 3 (13%) had permanent morbidity and 2 (9%) died within 1 month postoperatively. Eight (35%) had temporary neurologic complications that resolved without residual morbidity. Three (13%) had permanent neurologic complications. Seven (30%) had temporary systemic complications that resolved without residual morbidity. Three (13%) had permanent systemic complications with significant morbidity. There was a clear correlation between preoperation systemic morbidity score and outcome. There was a positive correlation between tumor size > 200 cm 3 and outcome. There was no correlation to tumor location. Conclusion : In our experience, meningioma removal in octogenarians showed good outcomes over 75% without long-term morbidity. There was a positive correlation to preoperative systemic comorbidity which should be considered.